NPI | 1043374911 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: UT 7201080-1202) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: CA dc28616) |
Enumeration Date | 2006-12-21 |
Last Update Date | 2010-09-03 |